Preliminary study on perforating artery infarction in middle cerebral artery territory using MR vessel wall imaging

SHEN Mi; GAO Peiyi; LIN Yan; SUI Binbin; CHEN Shuo; ZHOU Jian; XUE Jing; JING Lina

doi:10.19300/j.2017.L5738zt

Abstract：Objective To evaluate relationship between atherosclerosis activity of middle cerebral artery (MCA) and location and number of deep perforating artery infarction in MCA territory.Methods We prospectively assessed acute ischemic stroke patients treated in Tiantan Comprehensive Stroke Center of Beijing Tiantan Hospital during March 2014 to June 2017.A total of 49 patients,ranging from 28 to 73 years (mean age,55.5±10.6 years;45 men) had acute ischemic stroke within lenticulostriate territory of MCA on diffusion-weighted imaging.Intracranial large vessel 3D HR-MRI,namely vessel wall imaging,was performed in all patients within 2 weeks after stroke onset.Patients are divided into two groups according to presence of MCA plaque or not.Mann-Whitney U test and x2 test were respectively applied for comparison of lesion location and lesion number between the two groups.Results Clinical characteristics such as age,sex,hypertension,diabetes mellitus,and hyperlipoidemia showed no significant differences (P＞0.05).According to HR-MRI,30 (61.2％) patients had MCA plaque and 19 (38.8％) patients did not.The lowest layer was 2.5 (1.0,3.3) for the former group and 3.0 (2.0,4.0) for the latter group,and there was a significant difference between two groups (Z=-2.084,P=0.037).In the group with MCA plaque,19(63.3％) patients had singnlar lesion,and 11 (36.7％) had multiple lesions;while all patients had singnlar lesion in the group without MCA plaque (100％).There was a significant difference in the comparison of singular lesion number between two groups (P＜0.05).Conclusion MCA atherosclerotic plaques are related to location and number of deep perforating artery infarction.It helps in understanding mechanisms in stroke.